Have you ever wondered how feline jaw problems are diagnosed and treated? One common issue is temporomandibular joint (TMJ) luxation, which can cause discomfort and difficulty in eating for our furry friends. In this article, we will explore the diagnosis and various treatment options for TMJ luxation in cats.
Understanding TMJ Luxation and its Challenges
TMJ luxation occurs when the mandibular condyle, which is the part of the jaw joint that connects to the skull, becomes dislocated. This can happen due to trauma or underlying structural abnormalities. In chronic cases, organized fibrous tissue fills the joint space, making reduction more challenging (1). That’s why it’s crucial to address the issue as soon as possible.
Closed Reduction: A Non-Invasive Treatment Option
Once TMJ luxation is confirmed through imaging, veterinarians usually attempt closed reduction. Here’s how it works:
- The patient is placed in a comfortable position, usually sternal recumbency.
- A wooden dowel, such as a pencil, is positioned between the maxillary fourth premolar and the mandibular first molar to create a fulcrum.
- Gently applying manual pressure, the rostral mandibles and maxillae are closed to release the mandibular condyle from the articular eminence (3).
- The dowel is then turned gently to guide the mandibular condyle back into the mandibular fossa (3; Figure 6).
After reduction, the jaw movement is observed to ensure successful repositioning. Radiographs are taken to confirm the reduction (1). In most cases, the procedure is straightforward, and there’s no need for jaw movement restriction (1). However, a short course of a nonsteroidal anti-inflammatory drug (NSAID) and a soft diet for a couple of weeks can help control swelling and inflammation in the area (1).
Challenging Cases: When Further Measures Are Required
In some instances, closed reduction may not be successful, or there may be residual mandibular drift or re-luxation upon manipulation of the jaws. In such cases, restriction of oral movement becomes necessary. Here are the alternative treatments:
Tape Muzzle or Maxillomandibular Fixation
To maintain TMJ reduction, a well-fitted tape muzzle can be used, allowing a limited amount of movement (Figure 7). Another option is maxillomandibular fixation, which involves bonding the jaws together using a technique called interarcade composite bonding (6; Figure 8). This method provides rigid fixation, ensuring the joint remains stable during the healing process (2).
It’s important to note that interarcade bonding requires specialized training and equipment, often performed by veterinary dentists. The bonding material should be removed after 2 to 3 weeks to prevent joint ankylosis (2, 7). Additionally, the maxillary and mandibular canine teeth are bonded together with the mouth slightly open to allow for lapping of water and wet food. Adequate nutrition is ensured by placing an esophageal feeding tube (2, 3).
Advanced Cases: Open Reduction or Condylectomy
If TMJ luxation persists despite closed reduction attempts, open reduction or condylectomy may be necessary to restore functional occlusion (2). Due to the complexity of the TMJ region, involving neurologic, vascular, and musculoskeletal structures, it is highly recommended to refer these surgical procedures to a dentist or surgeon for optimal results (2).
Seeking Visual Understanding
If you’d like to see a video demonstration of how to correct TMJ luxation in a cat without additional trauma, you can visit the Katten TrimSalon Instagram page at this link: Katten TrimSalon. The video showcases the induction of anesthesia and the reduction process, providing a helpful visual demonstration.
Whether you’re a concerned cat owner or a veterinary professional, understanding the diagnosis and management of TMJ luxation in cats is crucial. By getting familiar with these treatment options, you can provide the necessary care and support for your feline companion’s jaw health.